Tracheal resection with patient under local anesthesia and conscious sedation

The authors describe the case of a woman with a 2-year history of dyspnea and stridor caused by a tracheal hamartoma. The patient underwent tracheal resection and end-to-end anastomosis under monitored local anesthesia and conscious sedation, which was achieved by boluses of ketamine and midazolam. Local anesthesia was obtained by the use of stepwise local infiltration of 2% lidocaine and 7.5 mg/mL ropivacaine during the operation. The patient remained awake during the entire procedure, thus permitting the movement of the vocal cords to be monitored. Mechanical ventilation was never required. The postoperative period was uneventful, and the patient did not describe having any discomfort.